Abstract
BACKGROUND--Bronchiectasis and pulmonary infections are common in patients with hypogammaglobulinaemia. Despite intravenous gammaglobulin treatment and appropriate antibiotics, a subgroup of patients remains with persistent localised pulmonary infection in segments where bronchiectasis had developed before appropriate treatment. As such localised pulmonary suppuration (segmental or lobar) may serve as a focus for progression of bronchiectasis, surgical resection of the involved segments may be considered. The outcome of pulmonary resection in four such patients is reported. RESULTS--Surgery was well tolerated except for one postoperative empyema. Information on follow up is available from 3.5 to 5 years. All patients experienced considerable reduction of symptoms including cough, sputum production, antibiotic use, and hospital admissions. CONCLUSIONS--Surgical resection of localised bronchiectatic segments should be considered in patients with hypogammaglobulinaemia with persistent localised suppuration and symptoms refractory to medical treatment.
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Selected References
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- Annest L. S., Kratz J. M., Crawford F. A., Jr Current results of treatment of bronchiectasis. J Thorac Cardiovasc Surg. 1982 Apr;83(4):546–550. [PubMed] [Google Scholar]
- Barker A. F., Bardana E. J., Jr Bronchiectasis: update of an orphan disease. Am Rev Respir Dis. 1988 Apr;137(4):969–978. doi: 10.1164/ajrccm/137.4.969. [DOI] [PubMed] [Google Scholar]
- Campbell D. N., Lilly J. R. The changing spectrum of pulmonary operations in infants and children. J Thorac Cardiovasc Surg. 1982 May;83(5):680–685. [PubMed] [Google Scholar]
- Dukes R. J., Rosenow E. C., 3rd, Hermans P. E. Pulmonary manifestations of hypogammaglobulinaemia. Thorax. 1978 Oct;33(5):603–607. doi: 10.1136/thx.33.5.603. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Dwyer J. M. Thirty years of supplying the missing link. History of gamma globulin therapy for immunodeficient states. Am J Med. 1984 Mar 30;76(3A):46–52. doi: 10.1016/0002-9343(84)90319-x. [DOI] [PubMed] [Google Scholar]
- Long A. A., Denburg J. A., Dent P. B. Hypogammaglobulinemia: therapeutic rationale. CMAJ. 1987 Nov 1;137(9):793–797. [PMC free article] [PubMed] [Google Scholar]
- Marcy T. W., Reynolds H. Y. Pulmonary consequences of congenital and acquired primary immunodeficiency states. Clin Chest Med. 1989 Dec;10(4):503–519. [PubMed] [Google Scholar]
- Roifman C. M., Lederman H. M., Lavi S., Stein L. D., Levison H., Gelfand E. W. Benefit of intravenous IgG replacement in hypogammaglobulinemic patients with chronic sinopulmonary disease. Am J Med. 1985 Aug;79(2):171–174. doi: 10.1016/0002-9343(85)90006-3. [DOI] [PubMed] [Google Scholar]
- Roifman C. M., Levison H., Gelfand E. W. High-dose versus low-dose intravenous immunoglobulin in hypogammaglobulinaemia and chronic lung disease. Lancet. 1987 May 9;1(8541):1075–1077. doi: 10.1016/s0140-6736(87)90494-6. [DOI] [PubMed] [Google Scholar]
